Two novel TSC2 mutations in renal epithelioid angiomyolipoma sensitive to everolimus

对依维莫司敏感的肾上皮样血管平滑肌脂肪瘤中出现两种新的 TSC2 突变

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作者:Tao Wang, Shunqiang Xie, Rongtuan Luo, Lianguo Shi, Peide Bai, Xuegang Wang, Rui Wan, Jiang Deng, Zhun Wu, Wei Li, Wen Xiao, Yongfeng Wang, Bin Chen, Kaiyan Zhang, Jinchun Xing

Abstract

People who suffers renal angiomyolipoma (AML) has a low quality of life. It is widely known that genetic factors including TSC2 mutation contribute to certain populations of renal AML-bearing patients. In this study, we are the first to identify novel TSC2 mutations in one Chinese renal epithelioid AML patient: c.2652C>A; c.2688G>A based on sequencing result from biopsy tissue. These two somatic mutations cause a translational stop of TSC2, which leads to mTORC1 activation. Given the fact that activation of mTORC1 ensures cell growth and survival, we applied its inhibitor, FDA-approved everolimus, to this woman. After months of treatment with everolimus, Computer-Tomography (CT) scan results showed that everolimus successfully reduced tumor growth and distal metastasis and achieved partial response (PR) to everolimu according to Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). Further Blood Routine Examination results showed the concentration of red cell mass, hemoglobin, white blood cell (WBC), platelets and hematocrit (HCT) significantly returned to normal levels indicating patients with these two TSC2 mutations could be effectively treated by everolimus.

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